[Risk analysis of gastrointestinal bleeding in patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention].

Objective: Of all spontaneous bleeding complications in patients with acute ST-elevation myocardial infarction (STEMI), upper gastrointestinal bleeding (UGIB) is the most common and of specific interest, because it can be prevented by several prophylactic measures. The purpose of this study was to investigate the in-hospital incidence, associated outcomes, and predictors of UGIB after STEMI. Methods: In this retrospective study, we analyzed the records of 2 791 patients with acute STEMI admitted to Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2018 and January 2022. The patients were divided into the UGIB group (n=61) and non-UGIB group (n=2 730) according to the presence or absence of upper gastrointestinal hemorrhage, respectively. Baseline clinical conditions, coronary lesions, in-hospital deaths, and in-hospital adverse events were compared between the two groups. Logistic regression analysis was also performed for risk factors that could lead to UGIB. Results: The in-hospital incidence of UGIB after STEMI was 2.2% (61/2 791). Hospital stay was significantly longer in the UGIB group [8(6, 12) days vs. 5 (4, 7) days, Z=3.28, P<0.001] and in-hospital mortality was significantly higher in the UGIB group than in the non-UGIB group (9.8% vs. 0.8%, χ2=0.63, P=0.001). Patients with UGIB were significantly older than those without UGIB (63±11 years vs. 58±11 years, t=-3.75, P<0.001). The serum creatinine level of UGIB patients was significantly higher than that of non-UGIB patients [(80(62, 98) mmol/L vs. 73(64, 84) mmol/L, Z=1.68, P=0.007], the red blood cell count of UGIB patients was significantly lower than that of non-UGIB patients [4.1(3.8, 4.6)×1012/L vs. 4.6(4.2, 4.9)×1012/L, Z=2.61,P<0.001], and the hemoglobin concentration of UGIB patients was significantly lower than that of non-UGIB patients [129(109, 141) g/L vs. 141(130, 152) g/L, Z=2.52,P<0.001]. Brain natriuretic peptide levels were significantly higher in UGIB patients than in non-UGIB patients [331(165, 644) ng/L vs. 181(89, 333) ng/L, Z=2.42,P<0.001]. Logistic regression analysis showed that age (OR=1.045, 95%CI 1.009-1.082, P=0.013); hemoglobin (OR=1.594, 95%CI 1.150-2.210, P=0.005); hematocrit (OR=0.181, 95%CI 0.060-0.546, P=0.002); and mean hemoglobin concentration (OR=0.845, 95%CI 0.752-0.951, P=0.005) were independent risk factors for UGIB in patients with STEMI. Logistic regression analysis of risk factors for in-hospital death revealed that concurrent UGIB was an independent risk factor for in-hospital death in patients with STEMI (OR=2.954, 95%CI 0.635-13.751, P=0.024). Conclusions: The incidence of in-hospital UGIB in STEMI patients was 2.2%, and the in-hospital mortality rate of STEMI complicated with UGIB increased to 9.8%. Concurrent UGIB was an independent risk factor for in-hospital death in patients with STEMI. The most important predictors of in-hospital UGIB in patients with STEMI were age, hemoglobin, hematocrit, and mean hemoglobin concentration.

[Clinical observation of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in patients with acute heart failure].

Objective: To observe the clinical effect of Qiliqiangxin capsule combined with recombinant human brain natriuretic peptide in acute left heart failure patients 7 days after onset as well as the effects of plasma MDA and ET-1. Methods: In total, 240 hospitalized patients with acute left heart failure from October 2017 to May 2021 were selected from the Department of Emergency and Critical Care Center of Beijing Anzhen Hospital, Capital Medical University and the Department of Cardiology of the Jilin Provincial People's Hospital. They were randomly divided into routine treatment group and combined treatment group, with 120 cases in each group. The routine treatment group was treated with vasodilation, diuresis, cardiotonic and recombinant human brain natriuretic peptide. The combined treatment group was treated with Qiliqiangxin capsules based on the routine treatment group. One week later, the changes in clinical efficacy, ejection fraction, left ventricular commoid diameter, and plasma BNP, MDA, and ET-1 were compared between the two groups before and after treatment. SPSS 11.5 statistical software was used. The measurement data was expressed in x¯±s, the independent sample t-test was used for comparison between groups, and the paired t-test was used for comparison before and after treatment within groups. Counting data was expressed as case (%), and the rank sum test was used for inter-group comparison. Result: In terms of clinical efficacy, the total effective rate of the combined treatment group was significantly higher than that of the conventional treatment group, and the difference was statistically significant (P<0.05). Compared with the routine treatment group, the left ventricular ejection fraction in the combined treatment group was significantly increased (P<0.05). The levels of plasma BNP, MDA and ET-1 were significantly decreased (P<0.05). Conclusion: Qiliqiangxin capsule combined with rhBNP treatment can effectively improve the clinical symptoms of acute heart failure, as well as reduce the lipid peroxidation product MDA content and endothetin ET-1 level in blood. The clinical application value of the Qiliqiangxin capsule needs to be further confirmed by further trials.

Effects of miR-101 on the proliferation and apoptosis of gastric mucosal epithelial cells via Nrf2/ARE signaling pathway.

OBJECTIVE: The aim of this study was to investigate the effects of micro-ribonucleic acid (miR)-101 on the proliferation and apoptosis of gastric mucosal epithelial cells through nuclear factor erythroid 2-related factor 2 (Nrf2)/antioxidant response element (ARE) signaling pathway. MATERIALS AND METHODS: Human gastric epithelial AGS (CRL-1739) cells were cultured in vitro. MiR-101 down-regulation or over-expression was achieved by transfection of inhibitors, or miRNA mimics, respectively. The apoptosis rate was detected by flow cytometry. Meanwhile, the targets of miR-101 were verified by the Dual-Luciferase reporter gene assay. Furthermore, the changes in protein levels were measured via Western blotting (WB). RESULTS: Up-regulation of miR-101 significantly promoted the apoptosis of gastric mucosal epithelial cells. The 3'-untranslated region (3'-UTR) of Nrf2 was highly conserved to combine with miR-101. The Luciferase reporter gene assay showed that transfection of miR-101 mimics could remarkably inhibit the relative Luciferase activity in cells. In addition, miR-101 overexpression markedly down-regulated the messenger RNA (mRNA) and protein expressions of Nrf2 in cells. CONCLUSIONS: MiR-101 plays an important role in regulating the proliferation and apoptosis of gastric mucosal epithelial cells by targeting the Nrf2-ARE signaling pathway.

Cytological mechanism of astragaloside IV in promoting repair of bone defects.

To explore the possible cytological mechanism underlying the role of Astragaloside IV in promoting the repair of bone defects, osteoblasts were cultured in vitro and identified using inverted phase contrast microscopy, alkaline phosphatase (ALP) staining and alizarin red staining.

[Risk factors and prognoses analysis of new-onset atrial fibrillation in patients with acute myocardial infarction].

Objective: To explore the risk factors and prognoses of new-onset atrial fibrillation (NOAF) in patients with acute myocardial infarction (AMI). Methods: A total of 468 patients with AMI were admitted into Beijing Anzhen Hospital for emergency pereutaneous coronary intervention (PCI). According to the NOAF occurred during hospitalization, the patients were divided into two groups: the NOAF (n=37) group and the non-NOAF (n=431) group. Parameters including general clinical conditions, coronary lesions, echocardiography, biochemical markers, C-reactive protein (CRP) , N-terminal pro-brain natriuretic peptide (NT-pro-BNP), and myocardial markers were collected. In-hospital mortality and incidence of in-hospital main adverse cardiovascular and cerebrovascular events (MACCE) were compared between the two groups. Logistic multivariate regression analyses were performed for the association between the risk factors and NOAF. Results: The incidence of NOAF was 7.9% in AMI patients undergoing emergency PCI. There were no significant differences in door-to-balloon time, weight, platelet counts, baseline serum creatinine (SCr), postoperative SCr, triglyceride, total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, uric acid, glycosylated hemoglobin A1c, preoperative medication, number of lesions, thrombus aspiration, location of myocardial infarction, and history of hypertension, diabetes, peripheral vascular disease and old myocardial infarction between the two groups. The percentage of women was in the NOAF group (32.4% vs. 16.7%, P<0.05) and subjects in this group were significantly elder than those in the non-NOAF groups [(66±10) years vs. (571±11) years, P<0.001]. Moreover, the levels of no-reflow rate (40.5% vs. 12.6%, P<0.001) , CRP [25.2 (15.43, 29.97) mg/L vs.5.21 (2.33, 16.98) mg/L, P<0.001], white blood cell counts [(11.19±3.44)×10(9) vs. (9.91±3.23)×10(9), P=0.022], NT-pro-BNP [(652.6±108.8) ng/L vs. (258.3±105.9) ng/L, P<0.001], and troponin I (TnI) [20.41(1.78, 87.89) µg/L vs.7.72(1.29, 36.39) µg/L, P=0.006] were significantly higher in the NOAF group than in the non-NOAF group, while left ventricular ejection fraction [(47.70±7.34)% vs. (53.35±8.05)%, P<0.001], and hemoglobin [137.0(125.5, 146.0) g/L vs.144.0(133.0,156.0) g/L, P=0.042] were significantly lower in the NOAF group than the non-NOAF group. Patients in the NOAF group had significantly longer hospital stay than those in the non-NOAF group [(8.7±5.6) d vs. (6.0±2.3) d, P=0.007]. The in-hospital mortality (8.1% vs 1.4% P=0.004) and the incidence of in-hospital MACCE (37.8% vs. 7.7%, P<0.001) in the NOAF group were significantly higher than those in the non-NOAF group. Logistic multivariate regression analyses showed that age (HR 1.083, 95%CI 1.028-1.141, P=0.003), CRP (HR 1.116, 95%CI 1.049-1.187, P=0.001), NT-pro-BNP (HR 1.463, 95%CI 1.001-4.064, P=0.001) and no-reflow (HR 4.388, 95%CI 1.006-19.144, P=0.049) were independent predictors of NOAF after AMI. Conclusions: Age, elevated levels of CRP, NT-pro-BNP, and the absence of no-reflow are risk factors for incident NOAF in patients with AMI in hospital.

[Clinical effectiveness and safety of ticagrelor in patients after PCI because of acute non ST segment elevation myocardial infarction].

Objective: To observe the clinical effectiveness and safety of ticagrelor in patients after percutaneous coronary intervention (PCI) because of acute non ST segment elevation myocardial infarction (NSTEMI) in China. Methods: A total of 240 patients with NSTEMI were analyzed retrospectively from Beijing Anzhen hospital between Jan 2013 and Jan 2015, with 113 patients in the clopidogrel group, 127 in the ticagrelor group. ADP-induced platelet aggregation was investigated 1, 3 and 6 month later after PCI, and major adverse cardiac events (MACE) and thrombolysis in myocardial infarction (TIMI) bleeding were followed-up for 6 months. Results: ADP-induced platelet aggregations of the ticagrelor group [(29±5)%, (29±6)%, (26±7)%] were decreased significantly compared with the clopidogrel group [(50±9)%, (49±9)%, (46±8)%] 1, 3 and 6 month later after PCI (P<0.01). Compared with the clopidogrel group (17.7%), the incidence of MACE of ticagrelor group (7.09%) was significantly decreased 6 month later after PCI (P<0.05), but there were no statistical differences in the incidence of TIMI major bleeding and secondary hemorrhage between the two groups (P>0.05). Conclusion: Ticagrelor combined with aspirin can decrease the MACE incidence of NSTEMI, and do not increase TIMI major bleeding and secondary hemorrhage.

[Review of numerical simulation study of Stanford type B thoracic aortic dissection].

According to the previous studies, some key indicators such as the hemodynamic parameters (pressure, flow rate, shear stress, etc.) as well as the geometry and the location of tear are closely related to the development of aortic dissection but are hard to measure in vivo. With the help of computational fluid dynamic method, a promising way is just shown to investigate the mechanisms and treatment of aortic dissection from the perspective of hemodynamics by constructing a three-dimensional model to simulate blood flow. This paper presents a systematic review of the development of aortic dissection research and the major research progress of computational fluid dynamics applied to the analysis of aortic dissection.

Improved protocol for extracting genomic DNA from frozen formalin-fixed tissue resulting in high-quality whole mtDNA.

Formalin fixation and paraffin embedding is widely used for convenient and long-term storage of tumor tissue and precious sources to perform genetic studies. However, DNA fragmentation is one of the major flaws of genomic DNA isolation from formalin fixation tissues, which limits its further usage. Here, we present an improved method for isolating high-quality genomic DNA from formalin fixation tissue. We obtained high-quality genomic DNA of more than 20 kb from samples frozen for more than 2 years. Furthermore, to verify DNA quality, the whole mitochondrial DNA (mtDNA) genomes from the normal and tumor tissue of the same patient were successfully amplified with two overlapping PCR fragments comprising more than 8379 bp in length for each fragment. In addition, the whole genomes were sequenced with a 48-well based primer panel in order to avoid potential sequencing errors from artificial recombination, which was further confirmed with an mtDNA phylogenetic strategy. Our improved DNA extraction method from formalin fixation tissue and sequencing strategy for entire mtDNA genomes will generate unambiguous sequence analysis results for clinical samples.

Practices and thinking of laboratory detection in the aid to West Africa to fight against Ebola.

BACKGROUND: The outbreak of Ebola virus disease in West Africa has brought great disaster to the people's health in affected countries. China dispatched first group of public health experts and medical staff to Sierra Leone in September 2014 to fight Ebola. METHODS: To systematically collect huge amount of primary data, and to make analysis, draw conclusions and lessons in terms of six aspects, respectively as training before departure, local disease information, track of epidemic situation, transformation of temporary laboratory, detection of Ebola virus samples as well as assessment through single blind test. RESULTS: 1) Our team has launched preparatory works in advance before going to Sierra Leone. 2) Malaria is the country's severest infectious disease. 3) Observation centers were overcrowded with large number of suspected cases being inspected, implying high risk of nosocomial infection. 4) A BSL-II laboratory with 3 work areas and 2 buffer areas was built, achieving several major functions within 6 days. 5) Confirmed by South African Raqqa laboratory, our detection accuracy reached 100%. 6) At one week before return, the daily average sample amount of our team reached 66 cases and our detection capability was equivalent to that of USA. CONCLUSIONS: Successful experience from fighting against Ebola in Sierra Leone could be summarized as: 1) Optimized processes and scientific security measures are prerequisite to improving the detection ability. 2) The close collaboration between laboratory and observation center has created a new model of China's foreign aid. 3) Comprehensive information investigation and training lay a solid foundation for the successful completion of tasks.

Construction of a Hep-2 cell line stably transfected with Livin shRNA.

OBJECTIVE: The aim of this study was to construct a eukaryotic expression plasmid with a short hairpin RNA (shRNA) targeting Livin in order to obtain a stably transfected Hep-2 cell line with a reduced expression of Livin. METHODS: The shRNA targeting Livin mRNA was designed, and a shRNA plasmid and a negative control plasmid were constructed. After amplification in E. coli, restriction endonuclease digestion and sequence confirmation, the plasmids were transfected into Hep-2 cells using Lipofectamine 2000. The stably transfected cell line was screened using G418, and inhibition of Livin mRNA and protein levels were detected using real-time PCR and western blotting, respectively. RESULTS: pGenesil-Livin-shRNA eukaryotic expression plasmid was successfully constructed and identified by sequencing. Green fluorescent protein (GFP) expression was observed in Hep-2 cells transfected with shRNA plasmids by fluorescence microscopy. The expression levels of Livin mRNA and protein decreased significantly in Hep-2 cells transfected with the shRNA recombinant plasmid. The mRNA level was reduced by 47.17 %, and the protein level was reduced by 34.25 %. CONCLUSION: The shRNA eukaryotic expression plasmid targeting Livin was successfully constructed, which could significantly inhibit the expression of Livin in laryngeal cancer Hep-2 cells. This provides a basis for future research on the function of Livin in Hep-2 cells, and gene therapy for laryngeal cancer.

Overexpression of protein kinase C ɛ improves retention and survival of transplanted mesenchymal stem cells in rat acute myocardial infarction.

We assessed the effects of protein kinase C ɛ (PKCɛ) for improving stem cell therapy for acute myocardial infarction (AMI). Primary mesenchymal stem cells (MSCs) were harvested from rat bone marrow. PKCɛ-overexpressed MSCs and control MSCs were transplanted into infarct border zones in a rat AMI model. MSCs and PKCɛ distribution and expression of principal proteins involved in PKCɛ signaling through the stromal cell-derived factor 1 (SDF-1)/CXC chemokine receptor type 4 (CXCR4) axis and the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (AKT) pathway were analyzed by immunofluorescence and western blot 1 day after transplantation. Echocardiographic measurements and histologic studies were performed at 4 weeks after transplantation, and MSC survival, expression of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), transforming growth factor ß (TGFß), cardiac troponin I (cTnI), von Willebrand factor (vWF), smooth muscle actin (SMA) and factor VIII and apoptosis in infarct border zones were assessed. Rat heart muscles retained more MSCs and SDF-1, CXCR4, PI3K and phosphorylated AKT increased with PKCɛ overexpression 1 day after transplantation. MSC survival and VEGF, bFGF, TGFß, cTnI, vWF, SMA and factor VIII expression increased in animals with PKCɛ-overexpressed MSCs at 4 weeks after transplantation and cardiac dysfunction and remodeling improved. Infarct size and apoptosis decreased as well. Inhibitory actions of CXCR4 or PI3K partly attenuated the effects of PKCɛ. Activation of PKCɛ may improve retention, survival and differentiation of transplanted MSCs in myocardia. Augmentation of PKCɛ expression may enhance the therapeutic effects of stem cell therapy for AMI.

Cemented hip hemiarthroplasty clinical observations on unstable intertrochanteric fracture in elderlies.

OBJECTIVE: To observe the clinical effect of steel cable or greater trochanter reattachment (GTR) device combined with cemented hip hemiarthroplasty for unstable intertrochanteric fracture in elderlies. MATERIALS AND METHODS: From July 2002 to June 2014, a total of 57 elderly patients with unstable intertrochanteric fracture, including 23 males and 34 females, were treated. Their ages ranged from 80 to 95 years, with the average of 83 years. According to Evans-Jensen classification, there were 18 type IIa cases, 13 type IIb cases and 26 type III cases. All patients received cemented bipolar femoral head replacement, using steel cable or GTR device to stabilize the unstable intertrochanteric fracture. RESULTS: All patients had successful operation procedure and were followed up for 36 months. Postoperative X-ray revealed satisfying postoperative position of artificial hip joint, without subsidence or loosening. Three cases with the use of steel cable alone to treat greater trochanter fracture suffered from rupture of steel cable. The patients using GTR device showed good reduction at the site of displaced greater trochanter fracture and a firm fixation. The clinical outcome measured with Harris hip score and Barthel Index at the time of final follow-up was significantly different between the groups. CONCLUSION: Hip hemiarthroplasty for elderly patients with unstable intertrochanteric fracture can meet the load bearing requirement at early stage and reduce postoperative complications prominently. Moreover, GTR devices can effectively solve the instability problem of posterior-lateral side of hip caused by displacement of greater trochanter in unstable intertrochanteric fracture.

Diversity and antimicrobial activity of endophytic fungi isolated from Cephalotaxus hainanensis Li, a well-known medicinal plant in China.

UNLABELLED: About 1051 endophytic fungi were isolated from leaves, branches, barks and stems of Cephalotaxus hainanensis Li from four sites in Hainan, China. The fungi were identified as 21 genera by morphology and ITS sequences. One dominant species was Phomopsis quercella in Hainan Tropical Botanical Garden and Bawangling Nature Reserve, with relative frequency of 42·06 and 34·88% respectively. Another dominant species was Colletotrichum boninense in Wuzhishan and Jianfengling Nature Reserves, with relative frequency of 36·84 and 46·97% respectively. Among the selected 21 endophytic fungi, 17 strains (80·95%) had activity against at least one pathogenic bacteria, and 14 strains (66·67%) exhibited activity against at least one fungal pathogens. Neonectria macroconidialis showed strong inhibition against Staphylococcus aureus (inhibition zone being 20 mm), Bacillus subtilis (14 mm) and Streptococcus agalactiae (28 mm). Xylaria sp. showed strong inhibition against Escherichia coli (20 mm), Rhizoctonia solani (20 mm) and Sclerotinia sclerotiorum (17 mm). Verticillium bulbillosum showed great activity against Strep. agalactiae (32 mm) and Fusarium oxysporum (22 mm). These endophytic fungi showed potentials in medicine development. SIGNIFICANCE AND IMPACT OF THE STUDY: Endophytic fungi from medicinal plants are an important source of novel and viable drugs. Cephalotaxus hainanensis Li is well known for leukaemia treatment and its endophytic fungi were isolated to investigate the diversity and antimicrobial activity. It was found that Ce. hainanensis Li had rich endophytic fungi, and some fungi showed strong antimicrobial activity against certain pathogens. These fungi can be used in medicine development.

Influence of Rho kinase inhibitor fasudil on late endothelial progenitor cells in peripheral blood of COPD patients with pulmonary artery hypertension.

OBJECTIVE: To investigate the influence of Fasudil, a Rho inhibitor on the number and functions of the late endothelial progenitor cells in peripheral blood of chronic obstructive pulmonary diseases (COPD) patients with pulmonary artery hypertension. BACKGROUND: It is not clear yet, whether Rho Kinase Inhibitor Fasudil can reduced pulmonary artery pressure through improving lung endothelial function. METHODS: 80 COPD patients with pulmonary artery hypertension were selected and divided into two groups: the treatment group and the control group, which had 40 patients, respectively. Changes in the number and function of the late endothelial progenitor cells in peripheral blood of the patients before and after the treatment were compared between the two groups. The changes on the pulmonary artery pressure were also compared. RESULTS: The number of the late endothelial progenitor cells in peripheral blood of the treatment group increased and the function was enhanced. The pulmonary artery pressure was reduced. The difference before and after the treatment and with the control group was statistically significant (p < 0.05). CONCLUSIONS: The Rho-kinase inhibitor Fasudil increased the number and enhanced the function of the late endothelial progenitor cells in peripheral blood of COPD patients with pulmonary artery hypertension (Tab. 3, Fig. 2, Ref. 17).

The role of the killer cell immunoglobulin-like receptor (KIR) "missing self" model in unrelated donor HSCT: a meta-analysis.

Some studies have found that donor-recipient killer cell immunoglobulin g-like receptor (KIRs) ligand compatibility or incompatibility influences the prognosis of hematopoietic stem cell transplantation between unrelated individuals, although the conclusions of these studies are controversial. We performed a meta-analysis concerning unrelated donor transplantation with donor-recipient KIRs compatible or incompatible. A higher 5-year overall survival rate (odds ratio [OR] = 1.93, 95% confidence interval [CI] = 1.03 to 3.61, P = .04) was found in KIR-mismatched transplantations; however, no difference was observed in the incidence of grade 2 to 4 acute graft-vs-host disease (OR = 0.94, 95% CI = 0.71 to 1.24, P = .64), 5-year relapse rate (OR = 1.05, CI = 0.75 to 1.47, P = .77), or transplantation/treatment-related mortality (OR = 0.61, CI = 0.15 to 2.51, P = .50). Our meta-analysis confirmed that incompatibility in KIR ligands favors 5-year overall survival rate but has no effect on the incidence of grade 2 to 4 acute graft-vs-host disease, relapse, or transplantation/treatment-related mortality.

Relaxor ferroelectricity and magnetoelectric coupling in ZnO-Co nanocomposite thin films: beyond multiferroic composites.

ZnO-Co nanocomposite thin films are synthesized by combination of pulsed laser deposition of ZnO and Co ion implantation. Both superparamagnetism and relaxor ferroelectricity as well as magnetoelectric coupling in the nanocomposites have been demonstrated. The unexpected relaxor ferroelectricity is believed to be the result of the local lattice distortion induced by the incorporation of the Co nanoparticles. Magnetoelectric coupling can be attributed to the interaction between the electric dipole moments and the magnetic moments, which are both induced by the incorporation of Co. The introduced ZnO-Co nanocomposite thin films are different from conventional strain-mediated multiferroic composites.

The application of ultrasonic harmonic scalpel in the radical surgery of gastric cancer.

PURPOSE: Ultrasonic harmonic scalpel has been widely applied to laparoscopic surgery of gastric cancer, but it has not been evaluated properly in open surgery. The objective of this study was to evaluate the value of the ultrasonic harmonic scalpel in the open radical surgery of gastric cancer. METHODS: 106 gastric cancer patients who had accepted distal D2 lymphadenectomy were included in this study. Patients were divided into ultrasonic harmonic scalpel (UHS) surgery group (50 cases) and conventional electric scalpel surgery group (56 cases). UHS surgery group patients were accepted surgery by ultrasonic harmonic scalpel. Instead, conventional electric scalpel surgery group patients were accepted surgery by monopolar electrocautery shovel and other traditional instruments. Then the average operation time, intra-operative blood loss, number of harvested lymph nodes, average post operative drainage within 3 days, and postoperative hospital stay were collected and compared between the two groups. RESULTS: The average operation time, blood loss, postoperative hospital stay in UHS group were significantly lower than traditional group (P < 0.05). The number of lymph node dissection was significantly higher than conventional surgery group (P < 0.05). There were no difference between two groups in average drainage within 3 days after surgery and the hospitalization costs (P > 0.05). In the presence of atherosclerotic patients, the average operation time, blood loss in UHS surgery group were significantly lower than the traditional group (P < 0.05). CONCLUSION: Ultrasonic harmonic scalpel may have better effect in the radical surgery of gastric cancer patients. It meets the requirements of the future development of precise surgical procedure.

Clinical research in individual information of celiac artery CT imaging and gastric cancer surgery.

OBJECTIVE: The objective of this study is to acquire CT images of the celiac artery by 64-multi-slice spiral CT angiography (64-MSCTA) in gastric cancer patients to facilitate gastric cancer surgery. METHODS: Preoperative 64-MSCTA was performed to observe the origin, course and anatomical variations of the celiac artery and vascular calcifications in 102 gastric cancer patients. RESULTS: (1) The celiac trunk mostly arose at the level between the 12th thoracic vertebra and the 1st lumbar vertebra; the mean inferior angle with the abdominal aorta was 63.5° (14°-159°), the mean length was 36.29 mm (5.80-73.58 mm), and its course showed many styles. (2) Of 102 gastric cancer patients, 34 patients (33.33 %) were observed with celiac artery variations of whom there were 27 patients with anatomical variations of the hepatic artery, 3 patients with anatomical variation of the left gastric artery and 1 patient with anatomical variation of the splenic artery; in 1 patient, the celiac trunk and the superior mesenteric artery originated from a common trunk. In other cases, it was observed with another variation. (3) The abdominal aortic calcified plaque was observed in 48 patients (47.1 %), and among them, 34 patients were more than 60 years old, and the existence of the abdominal aortic calcified plaque was related to age, significantly (P < 0.01). CONCLUSIONS: The 64-MSCTA largely improves our understanding of the origin, course and anatomical variations of the celiac artery and vascular calcifications in individual patient with gastric cancer. It is recommended that the 64-MSCTA of the celiac artery should be classified as a routine preoperative procedure in gastric cancer patients.